This blog post started as a reply to an editor who had rendered a revise and resubmit decision on my invited article based on a biased review. I realized the dilemma I faced was a common one, but unlike many authors, I am sufficiently advanced in my career to take the risk of responding publicly, rather than just simply cursing to myself and making the changes requested by the rogue reviewer. Many readers will resonate with the issues I identify, even if they do not yet feel safe enough making such a fuss. Readers who are interested in the politics and professional intrigue of promoting screening cancer patients for distress might also like reading my specific responses to the reviewer. I end with an interesting analogy, which is probably the best part of the blog.

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The issue regarding peer review is largely covered at the start of the piece so for those with limited mental stamina/time for reading, that might be all you have the time for.

I was never really conscious of how much power peer-reviewers have until I submitted a paper myself.

I could see that it could be a problem in the ME/CFS field with so many professionals wedded to the rehabilitation/graded activity model for the illness.

The rest of the post is about screening cancer patients for distress. I would need to read more to take a definite stance but it is is interesting.

Perhaps, although I'm not sure, the same arguments could have relevance with ME/CFS clinics where patients might be screened for distress. Anyway, my main reason to post it was to highlight the power peer reviewers have.

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Here's his bio from the end of the piece:

About James Coyne PhD

James C. Coyne, Ph.D. is Professor of Psychology in the Department of Psychiatry, Director, Behavioral Oncology Research of the Abramson Cancer Center, and a Senior Fellow at the Leonard Davis Institute for Health Economics, all at the Perelman Medical School of University of Pennsylvania. Additionally, he is Professor of Health Psychology, University of Groningen, the Netherlands. Previously, he served on the faculties of University of California, Berkeley and University of Michigan School of Medicine. Dr. Coyne has been elected a Fellow of the American Psychological Association, Society of Behavioral Medicine, and Academy of Behavioral Medicine. His critical commentaries have challenged whether psychosocial intervention extends the survival of cancer patients, whether recommended and mandated depression programs improve patient outcomes, and whether meta analyses of behavioral medicine commissioned by professional organizations are valid and credible. A 2008 systematic review and meta-analysis in JAMA of screening for depression among cardiovascular patients was designated by BMJ as one of the eight top papers of the year. He is known for presenting and defending controversial positions and for promoting reform of the clinical and health psychology journals. He is the co-author or editor of a number of books including the 2009 Screening for Depression in Clinical Settings: An Evidence-Based Review (Oxford University Press) with Alex Mitchell.

Interesting ... if I understand correctly, it looks like the author (Coyne) is rebutting the assumption in other papers that cancer patients should automatically be screened for psychiatric disorder. His stance is that it should be first studied to see what the costs and benefits of blanket screening is, especially since the info available shows that few people require psychiatric treatment as a result of cancer.

I also think Coyne has a good point about these "screening" methods being pushed by pharmaceutical companies, as well as the "cure" in pill form - and that replacing the patient talking to the doctor about the actual source of their distress and dealing with it.

Definitely a parallel to how ME/CFS is being treated - though instead of pills, they want to use the "psychiatric" screening (often drawing psychiatric conclusions based on physical symptoms) and diagnosis as a pretext for their special therapy.

And it ain't good if journals aren't allowing polite disagreement either via comments or via papers that have to survive review by those with established interests in a contrary viewpoint.

I think peer-review may be broken. Much sub-standard stuff gets past peer review, notably the PACE trial using a SF-36 Physical Function score of 60 to define both 'severely disabled' and 'normal' (and later 'recovery').

On the other hand, as this blog points out, peer reviewers can use hostile reviewing to keep ideas they don't like from being published. I did read the full blog and the hostile reviewer essentially conceded Coyne's central point that there isn't good evidence screening cancer patients for 'distress' is helpful or cost-effective. It also emerged from the 'Climategate' scandal emails that peer review was being used to keep conficting ideas out of the literature. What surprised me about that was how many scientists then said this was common practice in other fields too, and wasn't specific to climate research.

Overall, I wonder how good a job peer-review does of making sure that good science gets published.

A classic book, Thomas Kuhn, "The Structure of Scientific Revolutions," is relevant to this discussion--it is nearly always an "outsider" who reveals a new truth, and shows that the Emperor has no clothes. Peer reviewing has long been part of the machinery that keeps old ideas afloat. Which is not to deny that there are many good reviewers who can respond to new ideas, but much is left to the editor, who normally chooses the reviewers. Chris